EVOLVE HESI FUNDAMENTALS
ASSESSMENT FINAL PAPER 2026 DETAILED
SOLUTIONS GRADED A+
⩥ The nurse is administering medications through a nasogastric tube
(NGT) which is connected to suction. After ensuring correct tube
placement, what action should the nurse take next?
A. Clamp the tube for 20 minutes.
B. Flush the tube with water.
C. Administer the medications as prescribed.
D. Crush the tablets and dissolve in sterile water. Answer: The NGT
should be flushed before, after and in between each medication
administered (B). Once all medications are administered, the NGT
should be clamped for 20 minutes (A). (C and D) may be implemented
only after the tubing has been flushed.
Correct. Answer: B
⩥ A client who is in hospice care complains of increasing amounts of
pain. The healthcare provider prescribes an analgesic every four hours as
needed. Which action should the nurse implement?
A. Give an around-the-clock schedule for administration of analgesics.
,B. Administer analgesic medication as needed when the pain is severe.
C. Provide medication to keep the client sedated and unaware of stimuli.
D. Offer a medication-free period so that the client can do daily
activities. Answer: The most effective management of pain is achieved
using an around-the-clock schedule that provides analgesic medications
on a regular basis (A) and in a timely manner. Analgesics are less
effective if pain persists until it is severe, so an analgesic medication
should be administered before the client's pain peaks (B). Providing
comfort is a priority for the client who is dying, but sedation that impairs
the client's ability to interact and experience the time before life ends
should be minimized (C). Offering a medication-free period allows the
serum drug level to fall, which is not an effective method to manage
chronic pain (D).
Correct Answer: A
⩥ When assessing a client with wrist restraints, the nurse observes that
the fingers on the right hand are blue. What action should the nurse
implement first?
A. Loosen the right wrist restraint.
B. Apply a pulse oximeter to the right hand.
C. Compare hand color bilaterally.
D. Palpate the right radial pulse. Answer: The priority nursing action is
to restore circulation by loosening the restraint (A), because blue fingers
(cyanosis) indicates decreased circulation. (C and D) are also important
,nursing interventions, but do not have the priority of (A). Pulse oximetry
(B) measures the saturation of hemoglobin with oxygen and is not
indicated in situations where the cyanosis is related to mechanical
compression (the restraints).
Correct Answer: A
⩥ The nurse is assessing the nutritional status of several clients. Which
client has the greatest nutritional need for additional intake of protein?
A. A college-age track runner with a sprained ankle.
B. A lactating woman nursing her 3-day-old infant.
C. A school-aged child with Type 2 diabetes.
D. An elderly man being treated for a peptic ulcer. Answer: A lactating
woman (B) has the greatest need for additional protein intake. (A, C, and
D) are all conditions that require protein, but do not have the increased
metabolic protein demands of lactation.
Correct Answer: B
⩥ A client is in the radiology department at 0900 when the prescription
levofloxacin (Levaquin) 500 mg IV q24h is scheduled to be
administered. The client returns to the unit at 1300. What is the best
intervention for the nurse to implement?
, A. Contact the healthcare provider and complete a medication variance
form.
B. Administer the Levaquin at 1300 and resume the 0900 schedule in the
morning.
C. Notify the charge nurse and complete an incident report to explain the
missed dose.
D. Give the missed dose at 1300 and change the schedule to administer
daily at 1300. Answer: To ensure that a therapeutic level of medication is
maintained, the nurse should administer the missed dose as soon as
possible, and revise the administration schedule accordingly to prevent
dangerously increasing the level of the medication in the bloodstream
(D). The nurse should document the reason for the late dose, but (A and
C) are not warranted. (B) could result in increased blood levels of the
drug.
Correct Answer: D
⩥ While instructing a male client's wife in the performance of passive
range-of-motion exercises to his contracted shoulder, the nurse observes
that she is holding his arm above and below the elbow. What nursing
action should the nurse implement?
A. Acknowledge that she is supporting the arm correctly.
B. Encourage her to keep the joint covered to maintain warmth.
C. Reinforce the need to grip directly under the joint for better support.
ASSESSMENT FINAL PAPER 2026 DETAILED
SOLUTIONS GRADED A+
⩥ The nurse is administering medications through a nasogastric tube
(NGT) which is connected to suction. After ensuring correct tube
placement, what action should the nurse take next?
A. Clamp the tube for 20 minutes.
B. Flush the tube with water.
C. Administer the medications as prescribed.
D. Crush the tablets and dissolve in sterile water. Answer: The NGT
should be flushed before, after and in between each medication
administered (B). Once all medications are administered, the NGT
should be clamped for 20 minutes (A). (C and D) may be implemented
only after the tubing has been flushed.
Correct. Answer: B
⩥ A client who is in hospice care complains of increasing amounts of
pain. The healthcare provider prescribes an analgesic every four hours as
needed. Which action should the nurse implement?
A. Give an around-the-clock schedule for administration of analgesics.
,B. Administer analgesic medication as needed when the pain is severe.
C. Provide medication to keep the client sedated and unaware of stimuli.
D. Offer a medication-free period so that the client can do daily
activities. Answer: The most effective management of pain is achieved
using an around-the-clock schedule that provides analgesic medications
on a regular basis (A) and in a timely manner. Analgesics are less
effective if pain persists until it is severe, so an analgesic medication
should be administered before the client's pain peaks (B). Providing
comfort is a priority for the client who is dying, but sedation that impairs
the client's ability to interact and experience the time before life ends
should be minimized (C). Offering a medication-free period allows the
serum drug level to fall, which is not an effective method to manage
chronic pain (D).
Correct Answer: A
⩥ When assessing a client with wrist restraints, the nurse observes that
the fingers on the right hand are blue. What action should the nurse
implement first?
A. Loosen the right wrist restraint.
B. Apply a pulse oximeter to the right hand.
C. Compare hand color bilaterally.
D. Palpate the right radial pulse. Answer: The priority nursing action is
to restore circulation by loosening the restraint (A), because blue fingers
(cyanosis) indicates decreased circulation. (C and D) are also important
,nursing interventions, but do not have the priority of (A). Pulse oximetry
(B) measures the saturation of hemoglobin with oxygen and is not
indicated in situations where the cyanosis is related to mechanical
compression (the restraints).
Correct Answer: A
⩥ The nurse is assessing the nutritional status of several clients. Which
client has the greatest nutritional need for additional intake of protein?
A. A college-age track runner with a sprained ankle.
B. A lactating woman nursing her 3-day-old infant.
C. A school-aged child with Type 2 diabetes.
D. An elderly man being treated for a peptic ulcer. Answer: A lactating
woman (B) has the greatest need for additional protein intake. (A, C, and
D) are all conditions that require protein, but do not have the increased
metabolic protein demands of lactation.
Correct Answer: B
⩥ A client is in the radiology department at 0900 when the prescription
levofloxacin (Levaquin) 500 mg IV q24h is scheduled to be
administered. The client returns to the unit at 1300. What is the best
intervention for the nurse to implement?
, A. Contact the healthcare provider and complete a medication variance
form.
B. Administer the Levaquin at 1300 and resume the 0900 schedule in the
morning.
C. Notify the charge nurse and complete an incident report to explain the
missed dose.
D. Give the missed dose at 1300 and change the schedule to administer
daily at 1300. Answer: To ensure that a therapeutic level of medication is
maintained, the nurse should administer the missed dose as soon as
possible, and revise the administration schedule accordingly to prevent
dangerously increasing the level of the medication in the bloodstream
(D). The nurse should document the reason for the late dose, but (A and
C) are not warranted. (B) could result in increased blood levels of the
drug.
Correct Answer: D
⩥ While instructing a male client's wife in the performance of passive
range-of-motion exercises to his contracted shoulder, the nurse observes
that she is holding his arm above and below the elbow. What nursing
action should the nurse implement?
A. Acknowledge that she is supporting the arm correctly.
B. Encourage her to keep the joint covered to maintain warmth.
C. Reinforce the need to grip directly under the joint for better support.
